The healthcare industry has faced tremendous change and uncertainty for decades. Each year over the last decade, the challenges, issues, and opportunities facing HCEG members have been used to create the HCEG Top 10 list – a list of challenges, issues, and opportunities. Although most healthcare executives were likely comfortable about their priorities at the start of 2020, those healthcare leader priorities were certainly and quickly turned upside down by the emerging coronavirus pandemic. The best-laid plans demanded quick review, understanding, and revision as 2020 progressed.
COVID-19 Impact to Healthcare Leader Priorities
Accordingly, HCEG and our sponsor Change Healthcare performed a ‘flash survey’ of 228 healthcare leaders through June and July of last year to assess how COVID-19 impacted the priorities identified in the 10th Annual Industry Pulse research report – a research survey based on the 2020 HCEG Top 10 list.
The results of this COVID-19 flash survey update to the 2020 Industry Pulse were released in September of 2020. Since COVID-19 prevented the HealthCare Executive Group from hosting its 2020 Annual Forum that same month of September, a formal 2021 HCEG Top 10 list was not created but rather an Interim 2021 HCEG Top 10+ listwas assembled using findings from the flash survey and discussion among HCEG’s network of healthcare executives and industry leaders.
Updating Healthcare Leader Priorities as 2021 Unfolds
As 2020 ended and 2021 began, HCEG has been collecting additional information and insight into how the coronavirus pandemic and the 2020 presidential election have impacted the priorities of new and existing HCEG members and our network of partners and associates. We are also reviewing a list of 2021 healthcare predictions and trends shared by industry leaders.
While we are still collecting additional feedback from our members and performing a comparative analysis of information collected from our members to 2021 predictions and trends shared by industry leaders, it’s clear that the pandemic has resulted in new and changed priorities for health plans, health systems, and healthcare providers. Some initial findings based on the feedback provided by new HCEG members include:
“Consumer Experience” (#1) and “Costs & Transparency” (#2) were the most frequently noted priorities of new members.
“Data & Analytics” (#5) was the 3rd most referenced top priority. We’re reaching out to our members to gather more specifics about this foundational priority – among other priorities that were shared.
“Next Generation Payment Models” (#9) was the 4th most frequently noted priority.
“COVID-19 & Pandemic Preparedness” (#11) was frequently referenced with some new members adding “Patient & Healthcare Worker Safety” as a priority.
“Holistic Individual Health” (#7) was referenced by only two new members – both healthcare providers.
“Reimbursement Issues,” “Addressing Underfunding of Primary Care” and “Administrative Expense” – perhaps all considered a subset of “Next Generation Payment Models” – were listed as ‘new priorities’ – mostly by members associated with health systems and healthcare providers.
How has COVID-19 Impacted YOUR Priorities as a Healthcare Leader?
To help us further refine our Interim 2021 HCEG Top 10+ list, please consider sharing your priorities for 2021 via this simple, one-page survey. We’ll use your responses to create a more complete 2021 HCEG Top 10+ list and to help guide and create additional content as 2021 continues. You may also email us at [email protected].
Connect with the HealthCare Executive Group
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Please reach out to us at [email protected]if you have any questions or comments. If you are an executive of a health plan, health system, or healthcare provider organization, reach out to us at [email protected]for information on aspecial membership offer available through the end of January.
This is the final post of a 3-part series sharing physician perspectives on COVID-19 impact on the fall season. The information, insight, and ideas presented in this series originated from an informal discussion Ferris Taylor of the HealthCare Executive Group had with three physician executives:
COVID-19 Impact to Healthcare: Topics Discussed in This Series
The trio of physician executives discussed the following topics in the first and second posts of the series:
Part 1 Topics
Part 2 Topics
– Impact Factors Affecting Utilization of Services – Balancing Treatment to Avoid Ongoing Destruction of Demand for Non-COVID Services – Returning to School & Addressing Disadvantaged Populations – A Pediatric Physician on Sending Kids – Including Her Own – Back to School – Impacts on Minorities & Underserved Populations – Uncertainty in Testing and Understanding Prevalence – How Long Will We Be Dealing with COVID-19?
– COVID-10 Vaccines & Importance of Fall Flu Shots – Avoiding Other Illnesses or a Different Pandemic – Maintain Immunizations – Vaccinations for Underserved Populations – Messaging is Key – The Change to Telehealth: New Opportunities for Providers to Connect with Patients – Rethinking the Healthcare Supply-Chain – PPE as a Matter of Trust
Be sure to subscribe to our newsletter for more information of potential value to healthcare leaders and change-makers.
Live, Interactive Chat and Q&A – October 13th, 2020
On Tuesday, October 13, 2020, at 11:00 am PT/2:00 pm ET, Doctors DiLoreto, Vidal-Phelan, and Woo will present additional details and current insight on what can be expected for the coming fall season under COVID-19.
Lessons learned during the coronavirus pandemic can help to drive innovation that transforms preparedness, care delivery, quality, safety, efficiency, and patient experience over the coming months and years. The discussion continued with the physicians sharing some lessons learned and lessons to be learned.
Experiences from Southern Hemisphere – Seasonal Viruses at All-Time Lows
Dr. David:
“We’re also working with folks in the southern hemisphere right now. It’s very interesting they’re in the depths of winter in the southern hemisphere. The pandemic is certainly spreading and hitting places very hard; whether it’s Melbourne Australia, Santiago Chile, Johannesburg South Africa.
What’s interesting is that the incidence of other seasonal viruses is at an all-time low – historic lows. And it’s across a long spectrum so influenza, RSV, pneumococcus remains extraordinarily low suggesting that, obviously, measures such as social distancing, mask-wearing, hand washing are going to be more important than ever. And obviously vaccinating against flu and pneumococcus for older patients is going to be important.
Hopefully in North America, as we enter into winter, we’ll get similar effects that will suppress – like we did in the spring – some of the seasonal virus activity.”
Value of Encouraging Use of Masks
Dr. Johanna:
“And I think one important point about this is mask-wearing. And so, for example, places like Australia you just mentioned. In Chile, people are being compliant with using masks. So this is a message that we really need to also share with our community and the population that wearing your mask is important not only for COVID-19 but it does prevent the exposure to other viruses and illnesses.
And that I tell my pediatric patients wearing your masses showing your love is caring and so they do it, they do it very well.”
‘Long Haulers’ – The Unknown, Long-Term Impact of COVID-19
Dr. David Diloreto:
“I’d like to get your insights into are some of the issues we’re seeing with long haulers – folks who actually are continuing to demonstrate symptoms, troubling symptoms, for many weeks or months and potentially for some of them it could be long term.
We’re seeing widespread neurologic complications, cardiovascular complications – obviously there are aspects of this disease we don’t quite fully understand.”
Dr. David prompted fellow panelists to share a little bit about their concerns in younger individuals who may have had minimal symptomatology but have persistent symptoms going forward that don’t seem to be resolving.
Dr. Jason responded:
“One of the challenges is that when folks say “oh, this is a hoax or this is not real,” I think part of it is just recognizing what they’re seeing right and then what’s relevant to them. The challenge is when we have all this uncertainty when we have so many different messages, and there are all these aspects about the COVID-19 virus and its pathology in the body.
We are only beginning to get a sense that folks aren’t dying from pneumonia, they’re dying from micro infarctions throughout their lungs where it’s overwhelming the immune response. That’s killing them not the typical virus reproduction. And then the neurologic symptoms and the muscle symptoms where the virus is infecting whole body systems.
COVID-19 and Its Uncertain Pathology
We just have no knowledge of that. So, when folks see things it’s recognizing there’s still a lot of uncertainty about this. What’s right for you is what is going to be right for you. But do you want to do that in a vacuum or do you want to do that with better information? So how do we help better inform you about what those risks are because we know that the data is constantly evolving?
And how do we help you be alive for that so that we’re working together to figure it out because one person going back to work by themselves is not going to fix the economy? It’s how do we do this together and how do we address all the different concerns that people are going to be having – be it their economic ones or if they’re elder parents there are long-term consequences for the individual. How do we be alive to the things that are the highest priority for them in terms of what’s the information that they need to make a better decision?”
Financial Impact on Providers, Employer Groups, & Payers
The coronavirus pandemic has had a significant negative impact to the financial status of hospitals, physicians in private practice, and physicians employed by health systems. With patient volumes cut 60% or worse and with so many healthcare providers paid based on volume, many physicians have taken unprecedented hits to their revenue, and many organizations have furloughed or laid-off employees.
Dr. David shared how the coronavirus pandemic has likely forced all stakeholders – providers, employer groups, and payers including federal and state healthcare programs like Medicaid – into pursuing new value-based reimbursement models.
Employers Forced into New Reimbursement Models
“And employers who are really not that interested in thinking about value-based care – they just wanted to make sure their employees were happy with health insurance – now are looking at all kinds of – and these are small and medium-sized employers – anything they can do to eliminate costs now.
They’re much more interested in episode of care bundles and basically looking at structural reimbursement models that deliver their risk going forward. So our projections are that we (as individuals) and obviously state governments have been shielded to some degree from the economic impact by federal subsidies.
But if the economy is shut down in certain states and the tax base erodes, they’re going to have to look at their Medicaid programs in about 18 months totally differently. So there’s going to be much more cost reduction in that space.”
“So the folks that are also interesting to me are payers. If you look at what’s happened in 2020, many of them obviously – with the demand destruction – now are actually looking at significant surpluses on their financials for 2020. And they’re trying to really look at certain reserving capabilities including a reserve I never knew that existed called the premium discount reserve.
But it’s a way, in this instance, of being able to move these positive income statement effects off your books and onto your balance sheet and release it in future periods. But anyway, that’s probably not for this group.”
COVID-19 Forcing Physicians to Reevaluate Reimbursement
Dr. Jason Woo asked Dr. David Diloreto how the shift in the reimbursement payment system is going to affect our ability to be able to be more comprehensive in our coverage of the population?
Dr. David Diloreto responded:
“This is one of the most interesting aspects that for almost all of my clinical career, which is 30 years now, physicians generally viewed the least risky way to get paid was on a service basis. What’s really interesting is right now in large physician groups and in single-specialty groups and health system employee groups many specialists are thinking differently. They’ve been in situations now that seen demand from elective procedures (drop significantly) and they’re worried about the future.
If you can imagine being a bariatric surgeon with a large mortgage and trying to save money for college education, the world change doesn’t look like the world is going to come back that way. So they’re having grown-up discussions about changing the reimbursement models more to deliver that risk by going to employment; to going to safer ways of getting paid including fixed fees.”
Supporting & Caring for Front-Line Providers
In addition to financial impacts which were discussed later in the session, the physician panelists shared how the coronavirus pandemic has placed a huge physical and emotional burden on many frontline providers. Ferris prompted the physician panelists to share their thoughts on this quadrant of the Quadruple Aim:
What would be effective measures to decrease the burnout rate of physicians and everyone else fighting the coronavirus pandemic?
Dr. Jason:
“I think that in a lot of ways it’s going to be very healthy for health care providers to be able to connect to their patient’s. I think on the other side, those frontline providers that are still stuck with trying to take care of the folks that are coming through the ER or into the ICU is where there’s still not a lot of good information. And the struggle that they’re going to go through of trying to do the best that they can with all the uncertainty in the limitations that we have. I think for those folks we have to be really mindful that there’s a great burden that our traditional thought about what the role of the provider is. We have to help see beyond right and get into that.
What’s the best that you can do? What is not the best outcome that you’re going to be able to get, wish for every patient, but what’s the best that you can do within your circumstances. And being more for more mindful of the limitations that your role is going to be, that it is going to have. I think it’s hard because be it the lack of the supply chain, the lack of PPE, the challenges of what tests are available, or not available. Until that gets standardized, until there’s been able to get some trust in the data that they have and the testing methods that they, and the treatments available it’s just going to be hard to be a frontline provider.”
Dr. David added
“I think what we do need to get is the impact on providers, front line providers, who have been through the ringer. If you just think about what they’ve had to do throughout the spring into the summer – even in outpatient practices. Now all the PPE requirements on and off; all the changes in your practice; this is really taking a toll on providers right now.”
Get Your COVID-19 Questions Answered on October 13th
The discussion ended with a general agreement that the discussion could go on for hours. Accordingly, the three physicians agreed to make themselves available for a live, interactive follow-on chat with a Q & A opportunity on October 13, 2020 at 11:00 am PT / 2:00 pm ET.
Be sure to take advantage of this unique opportunity to learn more about what’s presented in this post – and please share it with your associates. And if you are not a subscriber to our newsletter, consider joining 5000+ other healthcare leaders, change-makers, and industry participants and subscribe today!
Late last month, the HealthCare Executive Group hosted an informal discussion with three physician executives on their observations, experiences, and insight about how COVID-19 has impacted healthcare and healthcare stakeholders. The theme of the discussion was: “What’s changed, what’s remained the same, and what can we expect in the coming fall season?”
HCEG’s Executive Director Ferris Taylor helped to facilitate the discussion and provided an HCEG perspective.
This is the second post of a three-part series sharing highlights of that conversation. See the first part here and consider subscribing to our newsletter to receive the final post and other information of value to healthcare leaders and change-makers.
Live, Interactive Follow-On Chat and Q&A – October 13th
For more detailed information on the topics presented in this series of posts and for a chance to interact with and ask questions of these physician leaders, join us on October 13, 2020 at 11:00am PT/2:00 pm ET for a live, interactive chat. The physician panelists will provide additional insight on what’s changed, what’s remained, and what can be expected for the coming fall and winter season under COVID-19.
Questions and requests for additional information shared by registrants prior to and/or during the live chat will be fielded by the panelists. Reserve your seat andsubmit your questions and comments today!Be sure to take advantage of this unique opportunity to learn more about what’s presented in this post – and please share it with your associates.
COVID-19 Vaccines & Fall Flu Shots
A significant part of the discussion continued on the development of a COVID vaccine and the importance of getting a seasonal flu shot to avoid undue burden to services and potential mis-diagnoses of the seasonal flu as COVID-19. Dr. Johanna shared:
Importance of Flu Shots – Minimize Avoidable Impacts
“We saw a decline of seasonal viruses during the spring and early beginning of the summer. I think right now you have to think about the monumental impact of children returning to school even if it’s for two days. Our children (Dr. Johanna’s children) have been with us since March 13th at 4 p.m. when the school released them and said ‘They’re not coming back. We don’t know when.’
And so our children haven’t really been exposed to a lot of other people, so we do know that children are going to be exposed not only to COVID-19 but all the other normal viruses that we see; or bacteria like strep throat. I think one of the important messages that I’ve been sharing with my family since day one is the importance of the flu vaccine. And there is a lot of misinformation and misunderstanding about the flu vaccine. People still believe that you get sick from the flu vaccine. That you are going to develop the flu from the flu vaccine. A lot of families, almost not even 50 % of the population in the United States, do not get the flu vaccine every year. “
Is Herd Immunity a Potential Solution?
Dr. Johanna continued:
“And so if we want to have a good herd immunity, it is important and I explained to the parents, that providing the flu vaccine to your child and your family is a way to combat a coronavirus. And they look at me like ‘Why? It’s a different virus.’
And I said: ‘because when your child gets sick with the flu, because you didn’t want to get the flu shot, we are going to have a very hard time differentiating between COVID-19 or the flu. So we have to test your child for both viruses and then there’s going to create a level of anxiety regarding school, quarantine and care that your child is going to need because we don’t know if it’s the flu.’”
Avoiding Other Illnesses or a Different Pandemic – Maintain Immunizations
“Now you can get the flu after getting the flu vaccine but you’re going to be protected from some of the major complications that we see when you have a natural illness and the duration of the illness is much shorter instead of being two to three weeks with the natural illness, it may be two to three days.
So I explained to the parents the importance of getting all the children’s immunizations on time. And believe it or not, there’s a critical important piece of information I need families to understand: Even though throughout most of COVID-19 pediatricians are open and family doctors are seeing children too, the importance of the well-child visit to be up-to-date and your teenagers, and the shots is critical – because we don’t want to change this pandemic for a measles epidemic or whooping cough so we have vaccines to prevent illnesses so let’s use them, let’s get them.”
Vaccinations for Underserved Populations – Messaging is Key
Dr. Jason shared the importance of reaching out to underserved populations is a trustful manner:
“I think there’s a communication point that has to be addressed- particularly for the underprivileged populations – is that getting vaccinations has to come from people who sound and look like them. It cannot come from the systems. And that’s where engaging your community outreach folks is going to be so critical to be able to get those. And it may not be having them coming to the hospital. It may be having the local pharmacy or having folks who are able to engage them there.
Because just as you point out Johanna, there’s so much mistrust and particularly folks are just when you can put the message through a medium that they’re more comfortable with that’s just going to be that’s so critical to address some of the social determinants that inhibit a lot of our understanding.”
Dr. David added:
“And that’s encouraging because it’s going to be needed coming forward. CVS for instance has 1800 testing sites right now around the United States that they’re expanding and they’re in negotiations to become vaccination centers. So just to your point that the neighborhood drug store being actually now a health hub where you can get vaccinated.”
One of the clear changes instigated by the coronavirus pandemic is the rapid adoption of telehealth. Stay-at-home and physical-distancing directives forced providers to rapidly adopt telehealth services or expand existing telehealth capabilities. Long hampered by reimbursement and physician adoption challenges, telehealth use exploded at the end of the 1st quarter of 2022 and has now become table-stakes.
Ferris prompted the panelists to share their take on telehealth and Dr. Johanna began:
Physicians Warming to Telehealth
“So I definitely also want to emphasize the importance of innovation and technology. I would talk to peers six months ago if somebody was telling me that I was going to do a tele-visit. I would have left. I was like: ‘I cannot see a pediatric patient by computer or phone.’
And now is I love it. And definitely it has pushed innovation into healthcare. It was slowly happening but to go from March to April and to see the dramatic jump into utilization of telemedicine is really important because it’s being used as a tool to connect with families; to engage patients; to continue allowing providers and physicians to continue providing the services that they (patients) need, and that is part of value-based care.”
Dr. Johanna urged physicians to answer the question:
“How can you think outside of the box in order to reach the population that is yours in order to prove it provides the best outcome for your patients?
And offered a reminder:
“And so the traditional model is one-to-one, in the office, with the physician. And we’re moving away from that model to having health care done in the home environment, remote monitoring, telemedicine, community health workers, other alternative sites of care – in order to complement what we call traditional medicine.”
Telehealth – New Opportunities for Providers to Connect with Patients
Dr. Jason on opportunities for telehealth: elective vs. non-elective procedures
“I think there are two different populations of providers that we need to think about:
1. Elective Procedures – Non-Emergent
“One is the folks who perform more of the elective stuff who are not the frontline workers now. In the sense that David was talking about, the folks who traditionally may have been doing elective surgeries or other sub-specialty care where there is an opportunity to transform the way they’re delivering care. In a way, I think that’s going to be more effective because of the opportunity to accept a lot of the modalities that telehealth has pushed forward.
I’ve been trying to do telehealth 20 years ago. I was trying to push telehealth in. I saw the radiologists, the mental health, and the psychiatrist, they loved it because there’s just so much more opportunity available to them when they’re not one-on-one in a fixed location anymore. And for those folks, I think there’s an opportunity to get back to actually better outcomes; to connect with your patients in a way that you hadn’t before.
It’s kind of like Zoom. We do a lot of training and I love the chat feature because there’s this ability to interact with folks that I hadn’t thought of before. And when you’re open to that I think that, in a lot of ways, it’s going to be very healthy for healthcare providers to be able to connect to the patients.”
“I think on the other side though is those frontline providers that are still stuck with trying to take care of the folks that are coming through the ER or into their ICU’S; where there’s still not a lot of good information. And the struggle that they’re going to go through of trying to do the best that they can with all the uncertainty and the limitations that we have.
I think for those folks we have to be really mindful that there’s a great burden that our traditional thought about what the role of the provider is that we as a physician, I think, we have to help (our patients) see beyond and get into ‘What’s the best that you can do?’”
The ready availability of PPE, medical equipment like ventilators, and certain pharmaceuticals was clearly called into question by the coronavirus pandemic. The lack of a $3.00 mask hampered providers’ ability to serve patients. And $30,000 ventilators are not just easily stocked without serious consideration.
Availability of Personal Protective Equipment – A Matter of Trust
Dr. Johanna shared her personal perspective from previous pandemics:
“I remember H1N1 and it was not like this. There is an element of trust as a provider, and also as a person working in the United States, that I should have not had to worry about where is my PPE coming from. It never crossed my mind in 2009 that I would not have enough PPE to protect myself against H1N1.
And if you recall, pregnant women were high risk for H1N1. And I was pregnant, caring for pediatric patients, with my second child and I never had to think about it twice. And so now, it’s the anxiety that providers have to know that they’re having the correct equipment in order to provide the care.
And also knowing so many of our peers are impacted by this disease and have died. It’s something that you need to pause and think about: What are we doing?”
Physician’s New Understanding & Appreciation for Supply Chains
Dr. David on physicians and their supply-chain relationship:
“The other interesting difference is that most physicians in December of last year (2019) probably couldn’t really describe a supply chain and certainly couldn’t talk to you about the strategic value of a supply chain.
Well, after they went through the PPE shortages and pharmacy shortages, they’re now really interested in working with their healthcare stakeholders and hospital stakeholders on how to optimize supply chain activities.
And so there’s a lot of work around nationalizing and onshoring. One of the shortages in the supply chain is the fact that countries nationalize these products, they’re not coming to North America. We’re having to work through that and that’s a big change. So with respect to payment models, we’re already seeing employers – remember there’s going to be some significant economic issues for companies/employers who are not interested in or thinking about value-based care.”
Part 3 Coming Soon – More COVID-19 Insight from Physician Executives
In the final post of this three-part series, highlights and details on the following topics from the informal discussion with Dr. Diloreto, Dr. Johanna Vidal-Phelan, and Dr. Jason Woo will be shared:
Lessons Learned and Lessons to Be Learned
Experiences from Southern Hemisphere – Seasonal Viruses at All-Time Lows
Value of Encouraging Use of Masks
‘Long Haulers’ – The Unknown, Long-Term Impact of COVID-19
Financial Impact on Providers, Employer Groups, & Payers
Employers Forced into New Reimbursement Models
Delayed Demand for Non-COVID Services
Live, Interactive Follow-On Chat and Q & A – October 13th
For more detailed information on the topics raised in this series of posts and for a chance to interact with and ask questions of these physician executives, join us on October 13, 2020, at 11:00 am PT/2:00 pm ET for a live, interactive follow-on chat and Q & A opportunity.
The physician panelists will provide additional insight into what’s changed, what’s remained the same, and what may be expected this fall and going into 2021. Questions and requests for additional information shared by registrants prior to and/or during the live chat will be fielded by the panelists.
Reserve your seat and submit your questions and comments today!Be sure to take advantage of this unique opportunity to learn more about what’s presented in this post – and please share it with your associates. And if you are not a subscriber to our newsletter, consider joining 5000+ other healthcare leaders, change-makers, and industry participants and subscribe today!
The HCEG Top 10 list of challenges, issues, and opportunities facing healthcare leaders have been a focus of the HealthCare Executive Group for over a decade. Planned for development by participants at our 2020 Annual Forum, the 2021 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives guides our content and programming throughout the coming year. It also serves as the basis for the Industry Pulse research that HCEG and our sponsor partner Change Healthcare have provided over the last decade.
Given the sea change forced by the coronavirus pandemic, the upcoming presidential elections, not hosting our in-person Annual Forum this year, and feedback received about providing more detailed information – a new approach will be used to develop the HCEG Top 10 list for 2021. Four main objectives guide the development of the 2021 HCEG Top 10 list:
Address Impacts from Coronavirus Pandemic & Upcoming Elections
The COVID-19 crisis has clearly altered healthcare priorities and the outcome of the November elections will most certainly do the same. It’s important for the 2021 HCEG Top 10 list to reflect these changed priorities and likely impact from election results.
Deeper Dive into Topics of Interest to Healthcare Executives
In an effort to provide more detailed input and insight into the challenges, issues, and opportunities facing all healthcare stakeholders, candidates for the 2021 HCEG Top 10 list include over 40 ‘sub-topics’ grouped into thirteen ‘themes.” These additional details are expected to provide more value based on the type of healthcare stakeholder: health plan/payer, provider, and risk-bearing provider.
All Virtual Identification, Selection & Ranking Process
Given the absence of our in-person 2020 Annual Forum that was scheduled for this month – and keeping with HCEG’s goal of providing more granular information – the process for identifying, selecting, and ranking core items on the HCEG Top 10 will take place virtually this year.
Open to All Healthcare Industry Participants
Historically, HCEG’s Top 10 process has been limited to HCEG members and attendees of our Annual Forum. Since HCEG is not hosting a physical annual forum this year, and in an effort to collect a wider perspective from a greater number of healthcare industry participants, we’re opening the 2021 HCEG Top 10 process to everyone who cares to participate.
Overview of 2021 HCEG Top 10 Development Process
The following is the high-level process for developing the new HCEG Top 10 list:
Identify “Initial List of 2021 HCEG Top 10 Themes & Sub-Topics” (COMPLETED)
Solicit Feedback on Initial List from Industry at Large (9/16/20 through 11/4/20)
Collect rankings of the Top 10 Sub-Topics identified in Step #2 (11/15/20 through 11/30/20)
Announce 2021 HCEG Top 10 List (12/14/20)
Help Select Candidates for the 2021 HCEG Top 10
The following are the major thematic categories proposed for the 2021 HCEG Top 10. A list of the sub-topics associated with each theme can be found here. Take Step 1 of the 2-Step 2021 HCEG Top 10 development process today. This survey should take less than 5 minutes to complete. If you are unable to complete the entire survey, we urge you to complete as many of the sections as possible that you consider important.
Thank you in advance for sharing your insight. Please contact us at [email protected] if you have any questions or comments. And join our newsletter to receive information, ideas, and insight for healthcare executives and change-makers: bit.ly/hcegnewsltr
The discussion was centered on COVID-19’s impact over the past months, what’s changed, what’s remained the same, and what they’ve each observed and learned over the past months – particularly from a clinical and public health role. The following topics were discussed:
Impact Factors Affecting Utilization of Services
The Change to Telehealth: New Opportunities for Providers to Connect with Patients
Balancing Treatment to Avoid Ongoing Destruction of Demand for Non-COVID Services
Rethinking the Healthcare Supply-Chain – PPE as a Matter of Trust
Returning to School & Addressing Disadvantaged Populations
Lessons Learned and Lessons to Be Learned
A Pediatric Physician on Sending Kids – Including Her Own – Back to School
Experiences from Southern Hemisphere – Seasonal Viruses at All-Time Lows
Impacts on Minorities & Underserved Populations
Value of Encouraging Use of Masks
Uncertainty in Testing and Understanding Prevalence
‘Long Haulers’ – The Unknown, Long-Term Impact of COVID-19
How Long Will We Be Dealing with COVID-19?
Financial Impact on Providers, Employer Groups, & Payers
COVID-10 Vaccines & Importance of Fall Flu Shots
Employers Forced into New Reimbursement Models
Avoiding Other Illnesses or a Different Pandemic – Maintain Immunizations
Delayed Demand for Non-COVID Services
Vaccinations for Underserved Populations – Messaging is Key
The information, insight, ideas, and predictions from this informal discussion are presented in a 3-part blog series and you can read Part 1, Part 2, and Part 3.
Live, Interactive Chat and Q & A – Physician Perspectives on COVID-19
Join this special October event, interact with and ask questions of these physicians Tuesday, October 13, 2020, at 11:00 am PT/2:00 pm ET. Questions and requests for additional information shared by registrants prior to and/or during the live chat will be fielded by the panelists.
The coronavirus pandemic has changed the world dramatically. Since late February, healthcare organizations have been largely in crisis mode – adapting to new testing and treatment demands and strategies – all while struggling to stay afloat emotionally, physically, and financially during these difficult times.
They’re dealing with supply chain challenges.
They’re adopting telehealth or accelerating their existing use of virtual health services.
They’re dealing with financial uncertainties due to either their focus on COVID-19 or due to the destruction of demand for non-COVID related services.
They’re navigating the harsh reality of a reimbursement system based on volume.
And there are many other changes caused by the pandemic and the response to the pandemic that are not yet known or fully understood.
And now, our school systems are struggling to safely re-open and bring some semblance of normality back to families and children. And as autumn rapidly approaches, addressing concerns about the potential impact from kids returning to school and the fall flu season are topics of discussion among many people.So what’s changed and what’s remained the same? What have healthcare leaders – particularly those serving in clinical and public health roles – observed and learned over the past months? What challenges, issues, and opportunities should they be focusing on? Is there a yin-yang opportunity available?
COVID-19 Insight, Information, & Ideas from Physician Leaders
To help answer these questions, the HealthCare Executive Group hosted an informal discussion with three physician executives. This post, the first in a series of three, shares some highlights and some details from that discussion.
Look for the remaining posts over the coming weeks and be sure to subscribe to our newsletter for more information on potential value to healthcare leaders and change-makers.
Dr. Jason Woo, MD (Dr. Jason) is a practicing board-certified obstetrician/gynecologist and a veteran with 31 years in the Commissioned Corps of the U.S. Public Health Service. Dr. Woo is a consultant at the Arbinger Institute.
In addition, HCEG’s Executive Director Ferris Taylorhelped to facilitate the discussion and provide HCEG perspectives. For more on the background and expertise of these participant leaders, see their bios here.
Live, Interactive Follow-On Chat and Q & A – October 13th
For more detailed information on the topics raised in this series of posts and for a chance to interact with and ask questions of these physicians, join us on October 13, 2020, at 11:00 am PT/2:00 pm ET for a live, interactive follow-on chat and Q & A opportunity.
The physician panelists will provide additional insight on what’s changed and what’s remained the same under COVID-19 with more on what expect this fall and going into 2021.
Questions and requests for additional information shared by registrants prior to and/or during the live chat will be fielded by the panelists.Reserve your seatand submit your questions and comments today!Be sure to take advantage of this unique opportunity to learn more about what’s presented in this post – and please share it with your associates.
Discussion Kickoff
Ferris Taylor welcomed everyone, offered a short summary of the goals of the informal discussion and passed the microphone (virtually of course) to Dr. Diloreto to kick off the discussion by sharing some information and insight collected over the last six months.
Physician Executives on COVID-19 Over the Last Six Months
“Supply chain issues this spring and the PPE and pharmaceutical shortages have presented new challenges, issues, and opportunities to analytics companies; re-doing their algorithms to account for co-covered impact factors.
Results of market demand forecasting and essentially what we’re seeing is a lot of what we have been virtual health. we’ve been we’ve probably compressed the trend for adoption of virtual health by five to seven years and now people are figuring out well that was bootstrapping and video conferencing with families but how do we really get the provider workflows adjusted so that this is meaningful and a productive way to deliver care.”
Impact Factors Affecting Utilization of Services
“The other thing we’re looking at that’s interesting is how the impact factors are affecting utilization of services. Early on we saw folks just avoiding the emergency room even staying home with symptoms of stroke and myocardial infarction. The high acuity services have returned but low acuity services have not, and we don’t believe they ever will.
These are things that basically probably shouldn’t have been in the emergency room to start with and folks are finding ways to deal with it. High acuity conditions like TAVR (Transcutaneous Aortic Valve Replacement) procedures and neurosurgical procedures are actually coming back really strong. People almost at full comparing the first six months of 2019 the first six months of 2020 basically the same utilization rates.
What’s interesting are more elective procedures including things like PE tubes in children – which have only come back to about 40 %. And so one of the issues there is could be a combination of factors. In the social distancing that was happening in the spring maybe there was less UTI and eye infections. On the other hand, families that we know are avoiding preventive services. There may be children with chronic ear infections not getting detected now. There are things that may play out long term that we have to figure out. So there’s a variable return of on the provider side of certain services.”
Dr. David went on to share more about:
Balancing Treatment to Avoid Ongoing Destruction of Demand for Non-COVID Services
They have to balance the treatment of COVID positive patients and non-COVID positive patients in the pandemic. And we watch those surges in places like Tampa and Los Angeles and Houston last month. And actually the provider community is getting a lot better at being able to balance that care. We know more about early intervention with certain treatments. There’s less folks going on onto ventilators and obviously we’re protecting the most vulnerable people in the elderly and institutions much better.
On the other hand, the impacts financially both from demand destruction as well as increased costs are huge. We’re seeing provider groups, hospitals and health systems really having to deal now with not only the near-term financial recovery but also some very significant economic issues. We’re looking at unemployment rates in Florida right now and in Orlando where there’s high rates of people employed in tourism and entry-level service jobs unemployment rate of about 20%.
Returning to School & Addressing Disadvantaged Populations
Should I send my children to school? What should I look for? Am I at risk? How will they (children) interact with aunts and uncles and grandparents? Is it really safe? And if they don’t go to school, what does that mean?
The impact in disadvantaged communities has been huge and it plays out in interesting ways not just in urban centers but was really interesting as we watched the surges in Los Angeles, Tampa and Houston as they came down the nearby rural areas particularly where you had either migrant workers and low-income workers in fields they were getting infected at very high rates. That’s probably sort of the fits and starts with this that we’re going to have throughout this pandemic until there’s widespread use of vaccines, herd immunity and more effective therapies
A Pediatrician on Sending Kids – Including Her Own – Back to School
Dr. Johanna was asked: What are you advising your patients on when they ask you: “Is it safe to send someone to school? As both a Practicing pediatrician and a parent of two school aged children, Johanna shared:
“So that’s a very important question and each family will have a different solution. I think that the first thing I have to tell parents and including myself as a parent is to empower the parent to make the decision. And there’s no wrong or right decision. You need to do what’s right for your family. And so, in partnership with the school district where your children are, I’m going to think about different things that had happened in the last 10 years for families and children. This has been one of those aspects that had created a lot of anxiety for families including myself. And I think a topic of importance to discuss is in regard to the home environment.
Most of the kids in the state of Pennsylvania are not having the opportunity to return to school full-time – so not five days. They’re doing a hybrid model or fully online. What is the impact for a working family that has to figure out how to come up with new solutions in regard to the care of the children during the days that they are not in school?”
Impacts to Minorities & Underserved Populations
“And the financial hardship that that may represent to a family. I’ve seen families make very challenging decisions where one of the parents is no longer working. So that parent can help with the children in the home environment for schooling. And other families are sending their children though they don’t want to, or they don’t feel comfortable because they have to go to work. I’ve seen a really dramatic impact in Latinos and minorities. As you know, Latino families/minorities families are mainly in the service industry – many of us. So what happens is that the level of exposure to COVID-19 is higher – disproportionately impacting African Americans and Latinos.
So you think about families and the impact in children and what that means to them is significant. It is a very challenging question. Parents ask me all the time in the pediatric practice and I respond with the answer: What is it that is important to you as a family? What is it that you can provide or not for your children education? And then we have a frank discussion about what the family will need to do.”
Uncertainty in Testing & Understanding Prevalence
Dr. Jason followed on with:
“I think, coming from the public health perspective particularly the FDA background, there’s just so much uncertainty in the testing and understanding incidents prevalence and what the outcome of an infection is. It’s so critical to be non-judgmental of what – as you pointed out Johanna – each family has to figure out what’s best for them.
As we’re providing services, part of the challenge is to be aware of the individuality that has to be accounted for each of the patients or each of the patients coming or families coming into the healthcare system and trying to figure out what’s right for them.”
A Perfect Petri “Diamond Princess” Dish – Wasted
“I think the one thing I kicked myself is, at the beginning of all this, I was so certain that we would have such good data from the date of the Diamond Princess. There were 3000 patients, they’ve been isolated, they’re dropping CDC resources in there, they’re doing sampling and we’re going to have so much information. And then after two weeks and nothing’s coming out. I had completely missed out.
We talk about the public health system being underfunded but I never expected us to be so poorly informed in terms of the data of the natural course of the infection, of infectivity, of how quickly it spreads and how it spreads. And so now with the plethora of different testing and the different way things are being approved by the FDA, I think it’s challenging because it’s just not the kind of data or standards that we would have had when we did Ebola, when we did Zika.
I wouldn’t say it’s for lack of knowing how to deal (with it), it’s just the challenge of not having a sort of a standard upfront approach prepared to go up front. And I don’t say politics. I don’t want to point fingers at all in this.”
Ferris mentioned reading about a poll asking physicians when physicians are expecting to be “on top of or ahead of COVID-19.” Ferris related that 50% of physician respondents are expecting that we won’t be on top or ahead of COVID until June of 2021.
Dr. David shared some other insight from his organization:
“Our projections are that we’ll be dealing with a pandemic situation probably into the fourth quarter of next year (2021) simply because the production and distribution of effective vaccines – and of course the early trials are encouraging – but it’s still a monumental undertaking. And also, we still don’t know the issues about long-term effectiveness (of any vaccine). There’s still a lot of volatility around that.”
“It seems like 2020 has been a decade. We’re finally in August and so in addition to dealing with an ongoing pandemic, we’ll have seasonal viruses and seasonal respiratory infections starting to come into play. Tell us a little bit about how you think it’ll affect frontline practices particularly with respect to testing strategies and recommendations for families.”
Dr. Jason countered:
“The question is: what do states do at this point in terms of making requirements that some of the school-age kids must meet to even participate?
I think New York already came out with the mandatory testing; I think California also as well. There’s certainly been a lot of confusion. There are factors that – as you point out – variables that if kids aren’t in school how does that affect exposure rates that we’re not going to project the uncertainty as a provider. I think that you’re presented with where folks are coming in is certainly so dependent upon where our testing capabilities are. And how much better knowledge we have. And how quickly folks can respond to that. And that’s why it’s very difficult.
It gets back to the uncertainty of how quickly these conditions continue to evolve and to what extent we’re able to get better information. There seems to be a lot of people working very hard at it but there’s just so much variation in the testing and so I think it’s going to be particularly hard for providers to make that (decision) but there’s just still a lot of uncertainty about what those actual prevalence rates are going to be with the different conditions.
I’d also ask, if kids aren’t in school, how does that affect the general trend of seasonal viruses?”
Part 2 Coming Soon – More COVID-19 Insight from Physician Executives
In the next post of this three-part series, highlights and details on the following topics from the informal discussion with Dr. Diloreto, Dr. Johanna Vidal-Phelan, and Dr. Jason Woo will be shared:
COVID-10 Vaccines & Importance of Fall Flu Shots
Avoiding Other Illnesses or a Different Pandemic – Maintain Immunizations
Vaccinations for Underserved Populations – Messaging is Key
The Change to Telehealth: New Opportunities for Providers to Connect with Patients
Rethinking the Healthcare Supply-Chain – PPE as a Matter of Trust
Live, Interactive Follow-On Chat and Q & A – October 13th
For more detailed information on the topics raised in this series of posts and for a chance to interact with and ask questions of these physician executives, join us on October 13, 2020, at 11:00 am PT/2:00 pm ET for a live, interactive follow-on chat and Q & A opportunity.
The physician panelists will provide additional insight on what’s changed, what’s remained the same, and what may be expected this fall and going into 2021. Questions and requests for additional information shared by registrants prior to and/or during the live chat will be fielded by the panelists.
Reserve your seatand submit your questions and commentstoday!Be sure to take advantage of this unique opportunity to learn more about what’s presented in this post – and please share it with your associates. And if you are not a subscriber to our newsletter, consider joining 5000+ other healthcare leaders, change-makers, and industry participants and subscribe today!
Employers and health plans interested in truly solving their musculoskeletal (MSK) issues must assemble a collection of disconnected vendors such as prevention/wellness, tele-PT, digital programs, expert medical opinion, centers of excellence (COEs) – resulting in a fragmented member care experience.
To address these failures in the continuum of MSK care, our most recent sponsor, Hinge Health, is pioneering the world’s most patient-centered Digital Clinic for back & joint pain. By expanding their clinical capabilities to provide an end-to-end Digital MSK Clinic, Hinge Health meets members along the MSK continuum of care from prevention to post-surgery.
Hinge Health’s Clinical Care Model Delivers Industry’s Best Engagement & Outcomes
Through its use of virtual physical therapy, behavioral health coaching, and digital sensor technology, Hinge Health’s virtual clinical care model delivers the industry’s best engagement and outcomes. The clinical expertise of our physical therapists paired with the motivational and behavioral training of our health coaches results in the industry’s highest adherence rate with a participant completion rate 3x the industry average.
Hinge Health’s solution addresses several key items on the 2020 HCEG Top 10 including Costs & Transparency (#1), Consumer Experience (#2), Holistic Individual Health (#6), and Accessible Points of Care (#8). As patients avoid doctor and hospital visits during COVID-19, Hinge Health’s at-home digital MSK care provides a more holistic and accessible approach to care resulting in better outcomes at a lower cost.
Musculoskeletal Outcomes Validated by Stanford, UCSF & Vanderbilt
With all the hype around digital health, many employers and health plans might be wondering: Do digital health solutions actually solve chronic back or joint pain and reduce medical spend? MSK issues are the number one cost driver for medical spend—outpacing other conditions such as diabetes and cancer. However, in the world’s largest digital MSK study, researchers from Stanford, University of California San Francisco, and Vanderbilt University, demonstrated that Hinge Health’s digital MSK solution directly results in better outcomes at lower spend.
With over 10,000 participants, the longitudinal cohort study revealed that Hinge Health resulted in:
69% average pain reduction–that’s 4x more pain reduction compared to opioids
58% average reduction in depression & anxiety
3 in 4 participants completed the program, making it the industry’s highest 12- week adherence rate
$5,012 medical claims savings per participant per year
With nearly 200 enterprise customers, Hinge Health partners with employers and health plans to address member MSK pain and reduce high medical costs. With Hinge Health’s fast and easy implementation process, customers can deliver at-home digital care to help resolve members’ chronic back and joint pain.
Customer Testimonials on Value of Musculoskeletal Program
Having nearly quadrupled their customer base in 12 months, Hinge Health is privileged to be the choice of 4 in 5 employers with a digital MSK solution including Boeing, AutoZone, US Foods, Southern Company, Walgreens, PwC, FujiFilm, and more.
Employee Engagement
Single, Coordinated Program
Evidence-Based Design
Additional Information on Hinge Health’s Musculoskeletal Platform
Check out the Hinge Health website, the Hinge Health blog, and the following information on how musculoskeletal solutions can help improve outcomes, lower costs, and improve member engagement.
For more information and to discuss how our sponsor partner Hinge Health can provide the best care for your employer or health plan members, contact Hinge Health today.
As we have all heard many times, “necessity is the mother of invention.“ Healthcare is facing what may be the crisis of the century and suddenly our slow-to-change industry is seeing radical change, some forced and others invented, never imagined even just a few months ago.
Many healthcare changemakers are aware that:
The use of telehealth and virtual care has exploded in the last month
Patient-specific risk scores and analytics are being used to bolster and guide virtual outreach, ventilation management, and patient care
Remote technologies can protect consumers, providers and health care workers from exposure and limit personal protection equipment (PPE) utilization
Could this forced acceleration of innovation be the “silver lining of COVID-19?”
Don’t Just Survive – Plan to Thrive on the Other Side of COVID-19
Bring your questions to this online, interactive online event and hear advice from experts as to specific actions you can take to survive these fast-changing times and what healthcare might look like on the other side of COVID-19. Helpful insights for everyone in healthcare will be shared.
Learn More and Register for this Complimentary Webinar Here
Learn from Government & Private ChangeMakers on the Front Line
Everyone paying attention to news reports and the unfortunate statistics conveying COVID-19’s impact can imagine the importance that governmental policy, interoperability rules, practical information exchange capabilities between payers, providers, and patient can have on defining, implementing, strengthening, and sustaining all stakeholders through the COVID-19 pandemic – equitably, reasonably and sustainably.
WEDI 2020 Virtual
The importance of effective health information exchange has never been greater. To learn more from public and private leaders and changemakers on the frontline about the above topics, consider attending WEDI’s 2020 Virtual Forum on Monday 5/4, Wednesday 5/6, & Thursday 5/7 of this week.
Bringing It All Together to Focus on the Individual Healthcare Consumer
Equally important to learning how public and private organizations are addressing COVID-19 imperatives, it’s important that healthcare organizations use a flexible, scalable approach to messaging consumers and employers.
Messages and communications need to be relevant and delivered quickly so that individuals – and managed groups – stay informed; and more likely to take the most appropriate actions. As the COVID-19 pandemic drives more individuals to become more engaged in their health and the care they may need – or want, innovative healthcare organizations have an opportunity to differentiate their brands and build trust by delivering customer experiences that exceed everyone’s expectations, even during a crisis.
Breaking Through the Barriers to Better Consumer Experience
Join the HCEG May 2020 Webinar Series event presented by our sponsor partner Zipari on Thursday, May 21st, 2020 11:00 am PT / 2:00 pm ET
This webinar will present a Consumer Experience (CX) framework for healthcare organizations to prioritize and manage consumer goals and messaging during COVID-19 via consumer experience technology. Actionable information and ideas on streamlining outreach to specific individuals prioritized across-departmental objectives will be presented.
Learn More and Register for this Complimentary Webinar Here
The historic cancellation of the 2020 HIMSS Conference & Exhibition has impacted the way healthcare leaders and change-makers obtain information, exchange ideas, and network with others. In the last two weeks, many conferences have canceled or are canceling their physical events and are ‘going virtual’ to salvage the content and speakers they had lined up for their events. Other conference organizers are scrambling to figure out how to support their attendees and exhibitors going forward. Indeed, the conference and media industry – healthcare or otherwise – are mapping and paying the digital freight to help ensure their future.
Here’s some information on the virtual events and content the HealthCare Executive Group, our sponsors, partners, and associates are sharing to make the best of the cancellations of major healthcare conferences like the 2020 HIMSS Conference & Exhibition. And a bit of history on how HCEG provides a year-round approach to supporting the information and networking needs of healthcare executives and change-makers.
HIMSS 20 Cancellation – Collaborating Virtually
Almost immediately after HIMSS Leadership announced the cancellation of the 2020 HIMSS Conference & Exhibition, a slew of announcements about virtual events and content sharing were made by various speakers, attendees, exhibitors, and others involved in the HIMSS20 conference. This cancellation was the first time in nearly 60 years that the HIMSS Conference was canceled. And no one: attendees, speakers, panelists, sponsors, exhibitors, and/or those hired to produce the 2020 HIMSS Conference & Exhibition have NOT been impacted in one way or another by this cancellation.
Information and Insight About the Future of Healthcare Conferences – Go Virtual
The comfort of meeting and exchanging ideas and information with each other at in-person events has changed. There’s no denying this fact. People are going to have to get comfortable with sharing information, making acquaintances, and networking with others in new, largely unknown and somewhat difficult to use, channels and platforms. Thankfully, the HealthCare Executive Group has decades of experience facilitating interaction between healthcare executives and the companies that support their mission.
In addition to our Annual Forum and quarterly Executive Leadership Roundtables, HCEG presents webinars, online discussion, podcasts and blog posts such as this post.
HCEG has also established both formal and informal partnerships with complementary organizations that also serve our members and other healthcare industry participants associates. These partnerships extend and complement the content, networking opportunities, and value offered by HCEG and its partners. For 2020, these partnerships include being a HIMSS Collaboration Partner and AHIP Educational Partner.
HCEG sponsors scheduled to present in Orlando have stepped up and performed the work to share most of their scheduled presentations. We urge you to check out these virtual shares – webinars, recordings, blog posts, and other information – from our sponsor partners:
See the Virtual On-Demand HIMSS20 Experience from Change Healthcare here.
Surescripts:
Webinar recordings, blog posts and other digital content intended to help HIMSS20 attendees understand how Cost & Transparency and the Consumer Experience are key to improving healthcare outcomes are shared here by Surescripts and in the following downloads.
Over the last week, dozens, if not 100’s, of virtual presentations and digital artifacts have been shared to help ameliorate the cancellation of the 2020 HIMSS Conference. Here are some of those digital shares of potential value:
The Near Future of Virtual & Intimate In-Person Events
Over the last week, since the 2020 HIMSS Conference has been canceled, a number of worldwide organizations, companies, and individuals have shared valuable insight into what may turn out to be the future of long-standing ‘initiatives’
Here are a few considerations:
How will healthcare leaders and change-makers obtain the leads they’ll lose from Cancelled Conferences and Events?
How will the current organizer dominatrix move forward over the next 12-24 months?
How will the organizer bring their conference or event online?
We’re pleased to announce the release of the 2020 Industry Pulse Report! This annual survey commissioned by the HealthCare Executive Group and Change Healthcare takes the pulse of a broad spectrum of healthcare industry leaders representing payers, providers (hospitals, doctors offices, & integrated delivery networks) and other industry participants from across the nation.
The 2020 Industry Pulse Report is based on the 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives and change-makers. In its 10th year of production, the survey drew a record number of respondents (445), 80% of who held titles of director level or above shared their responses and comments on survey questions, 25% of those participants were from the C-Suite.
Results of the initial analysis of survey data were announced earlier this month and can be accessed here. Look for the release of additional insight based on the 2020 Industry Pulse Report and the 2020 HCEG Top 10 including webinars, podcasts, conference presentations and additional article posts over the coming weeks and months leading up to HCEG’s Annual Forum in September.
Consumer Experience + Value-Based Care = Consumer Centricity
The 2020 Industry Pulse Report provides deeper insight into the topics of healthcare cost and outcomes transparency, the healthcare consumer experience, and adopting next-generation payment models like value-based care. The information and analysis contained in the report help to understand current progress being made by providers and payers on the topics identified as most important by healthcare leaders. The survey was designed to elicit and share information on some of the methods being used, priorities, and areas of alignment and disagreement between the primary survey respondents: providers and payers.
See ‘Additional Areas of Insight’ below for other HCEG Top 10-related items addressed in the 2020 Industry Pulse Report.
Consumer-Centric Strategy Varies Between Payers & Providers
In terms of existence and maturity of a Consumer-Centric Strategy, there were areas of alignment – and disagreement – between the largest two groups of survey participants: providers and payers. These data are presented across a 4-point continuum of Consumer-Centric Strategy:
No Consumer-Centric Strategy
Nascent Consumer-Centric Strategy: single-point solutions, but no unifying organization-wide approach
Intermediate Consumer-Centric Strategy: a consumer-centric approach, actively investing in technologies but no company-wide impact
Full Consumer-Centric Strategy: fully implemented tools and technologies to achieve consumer-centric outcomes and able to effectively measure improvements
Areas of alignment – and disagreement – between the survey’s two largest respondent groups Providers (hospitals, doctors offices, & integrated delivery networks) and Payers (health plans) presented overall responses from these core survey participant groups across a 4-point continuum of Consumer-Centric Strategy.
Disagreement on Current State of Healthcare Consumer Centricity
It’s no surprise there’s disagreement regarding the responsibility, readiness, and challenges facing providers and payers in their transformation to address consumer-centricity. The report reveals both providers and payers are split in the area of value-based care – perhaps the most common Next Generation Payment Model:
Payers are much more likely to have robust consumer-centric strategies and providers are much more likely to have no consumer-centric strategy at all.
Payers and providers disagree on who’s best positioned to provide cost and quality data to consumers.
Payers are much more likely to have migrated to value-based care models while providers are still predominantly offering fee-for-service models.
Who’s Best Positioned to Support Consumer Healthcare Journey?
Regardless of role, most respondents think payers (31%) are best positioned to provide cost and quality data to healthcare consumers. Some survey respondents noted others: “Health Information Networks”, “Insurance Agents”, and “Government Agencies.”
However, most respondents favor providers nearly 3 to 1 as being best positioned to support the consumer on their healthcare journey. Some respondents shared that “Retailers and innovators,” “Case Managers,” and “Friends and Family” are best positioned to support individuals on their healthcare journey.
Financial Improvements to Positively Impact Consumer Satisfaction
Survey participants ranked a series of financial or billing improvements based on how they perceived those improvements as improving customer satisfaction. Turns out, addressing the basics that consumers have come to expect are perceived as driving the most value.
Clear Identification of In-Network vs. Out-of-Network Providers
Consolidated Billing from Multiple Providers
Elimination of Surprise Billing
Online Payment Capabilities
Plain-Language EOBs and Simplified Invoicing
Real-Time Point-of-Service Billing
Simplified Benefit Explanations/Navigation
Simplified/Flexible Payment Options
Participants were also asked to rank other non-clinical improvements based on their potential to positively impact consumer satisfaction.
Additional Areas of Insight – 2020 Industry Pulse Report
Beyond the topics noted above, the 2020 Industry Pulse Report includes insight into the following challenges, issues, and opportunities facing healthcare organizations.
Barriers to Adopting Value-Based Care
Payers cite lack of or limited IT infrastructure as an impediment to value-based care while providers cite unclear or conflicting performance measures and regulatory changes/political uncertainty
How They’re Addressing Social Determinants of Health (SDOH)
Payers and providers differ on the type of sdoh-related data they are capturing
Effectiveness of Artificial Intelligence and Machine Learning
Providers are significantly more likely than payers to state Health System Efficiency has been positively impacted by AI and machine-learning
Payers are significantly more likely to say Reducing Costs has been positively impacted.
Drivers of Demand for Interoperability
Payers view Regulatory Changes as driving interoperability while Providers rank Physician-Driven Initiatives as a driver of the demand for interoperability
Top Reasons for Continued Cybersecurity Breaches
Across all C-Suite respondents, nearly 25% believe that Cybersecurity is not Recognized as a Priority at the Executive/Board Level.
Information on methods used, areas of alignment, respective priority, and disagreement between various supply-side stakeholders on the above areas can be of unique value to payers, hospitals, doctors’ offices, and integrated delivery networks.
Get Your Copy of the 2020 Industry Pulse Report
Download the 2020 Industry Pulse Report for more details on the above and other insights collected by the 2020 Industry Pulse Report. And look for more analysis and commentary on the Industry Pulse survey from HCEG, our sponsor partners and media covering the healthcare industry.
If you have any questions you have about the 2020 Industry Pulse Report, the 2020 HCEG Top 10, or the HealthCare Executive Group, please feel free to email us.
More Insight for Healthcare Leaders and Change Makers
The 2020 Industry Pulse Report and the HCEG Top 10 list of challenges, issues, and opportunities demand change and innovation from all stakeholders – particularly within the ongoing uncertainty of U. S. healthcare reform and an election year. Consider the following if you’d like to dive deeper into these topics and connect with other healthcare leaders and change-makers.
Participate in our 2020 Annual Forum in Boston, MA on Sept 21-23, 2020
Please consider sharing your insight, experiences, and opinion as your perspective will help define the issues facing healthcare and reveal how key industry participants are acting to transform the healthcare delivery system.
Recent 3rd-Party Analysis and Coverage of the 2020 Industry Pulse Report
Payer/Provider Memberships: Candidates are organizations that provide direct insurance benefits (policies, financial, administrative services and other risk-bearing and ASO services) and/or direct health services (medical, dental, vision, etc.) to groups or individuals, either as stand-alone entities or as a subsidiary under a commercial entity.
Individual Membership: Candidates are executives from Payer/Provider Membership eligible organizations.
Alumni Membership: Past HCEG members who are unaffiliated with vendor organizations. Vendors provide products and services to HCEG member candidate organizations to better serve individuals.
“We’re also working with folks in the southern hemisphere right now. It’s very interesting they’re in the depths of winter in the southern hemisphere. The pandemic is certainly spreading and hitting places very hard; whether it’s Melbourne Australia, Santiago Chile, Johannesburg South Africa. 
“And employers who are really not that interested in thinking about value-based care – they just wanted to make sure their employees were happy with health insurance – now are looking at all kinds of – and these are small and medium-sized employers – anything they can do to eliminate costs now. 
So what’s changed and what’s remained the same? What have healthcare leaders – particularly those serving in clinical and public health roles – observed and learned over the past months? What challenges, issues, and opportunities should they be focusing on? Is there a yin-yang opportunity available?
For more detailed information on the topics raised in this series of posts and for a chance to interact with and ask questions of these physicians, join us on October 13, 2020, at 11:00 am PT/2:00 pm ET for a live, interactive follow-on chat and Q & A opportunity.
